{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:56Z","timestamp":1791821096281,"version":"4.3.4"},"reference-count":53,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,19]],"date-time":"2023-02-19T00:00:00Z","timestamp":1676764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Understanding which factors predict the outcome of internet-based cognitive behavioral therapy for insomnia (iCBT-I) may help to tailor this intervention to the patient\u2019s needs. We have conducted a secondary analysis of a randomized, controlled trial comparing a multicomponent iCBT-I (MCT) and an online sleep restriction therapy (SRT) for 83 chronic insomnia patients. The difference in the Insomnia Severity Index from pre- to post-treatment and from pre-treatment to follow-up at 6 months after treatment was the dependent variable. Prognostic and treatment-predictive factors assessed at baseline were analyzed with multiple linear regression. The shorter duration of insomnia, female gender, high health-related quality of life, and the higher total number of clicks had prognostic value for a better outcome. Other factors were found to be prognostic for outcome at the follow-up assessment: treatment with benzodiazepines, sleep quality, and personal significance of sleep problems. A high level of dysfunctional beliefs and attitudes about sleep (DBAS) was a moderator for better effects in the MCT at post-treatment assessment. Various prognostic factors (e.g., duration of insomnia, gender, or quality of life) may influence the success of treatment. The DBAS scale may be recommended to select patients for MCT rather than SRT.<\/jats:p>","DOI":"10.3390\/diagnostics13040781","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T05:57:52Z","timestamp":1676872672000},"page":"781","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Guided Internet-Based Cognitive Behavioral Therapy for Insomnia: Prognostic and Treatment-Predictive Factors"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5051-2106","authenticated-orcid":false,"given":"Polina","family":"Pchelina","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone B.","family":"Duss","sequence":"additional","affiliation":[{"name":"Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-5468","authenticated-orcid":false,"given":"Corrado","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Berger","sequence":"additional","affiliation":[{"name":"Departement of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, 3012 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Krieger","sequence":"additional","affiliation":[{"name":"Departement of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, 3012 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4535-0245","authenticated-orcid":false,"given":"Claudio L. A.","family":"Bassetti","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Urech","sequence":"additional","affiliation":[{"name":"Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/jsr.12594","article-title":"European guideline for the diagnosis and treatment of insomnia","volume":"26","author":"Riemann","year":"2017","journal-title":"J. Sleep Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1177\/0269881119855343","article-title":"British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update","volume":"33","author":"Wilson","year":"2019","journal-title":"J. Psychopharmacol."},{"key":"ref_3","unstructured":"Perlis, M.L., Jungquist, C., Smith, M.T., and Posner, D. (2005). Cognitive Behavioral Treatment of Insomnia: A Session-by-Session Guide, Springer. [1st ed.]."},{"key":"ref_4","unstructured":"Perlis, M.L., Aloia, M., and Kuhn, B. (2010). Behavioral Treatments for Sleep Disorders, Academic Press."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/sleep\/29.11.1398","article-title":"Psychological and behavioral treatment on insomnia: An update of recent evidence","volume":"29","author":"Morin","year":"2006","journal-title":"Sleep"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1037\/a0015446","article-title":"Similarities and differences between practitioners of psychotherapy in Sweden: A comparison of attitudes between psychodynamic, cognitive, cognitive\u2013behavioral and integrative therapists","volume":"19","author":"Larsson","year":"2009","journal-title":"J. Psychother. Integr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4321\/S0213-61632008000100005","article-title":"Are individual and group treatments equally effective in the treatment of depression in adults? A meta-analysis","volume":"22","author":"Cuijpers","year":"2008","journal-title":"Eur. J. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.3399\/bjgp14X677176","article-title":"GPs\u2019 management strategies for patients with insomnia: A survey and qualitative interview study","volume":"64","author":"Everitt","year":"2014","journal-title":"Br. J. Gen. Pract."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e13169","DOI":"10.1111\/jsr.13169","article-title":"Treating insomnia in Swiss primary care practices: A survey study based on case vignettes","volume":"30","author":"Linder","year":"2021","journal-title":"J. Sleep Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Seyffert, M., Lagisetty, P., Landgraf, J., Chopra, V., Pfeiffer, P.N., Conte, M., and Rogers, M. (2016). Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149139"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.smrv.2015.10.004","article-title":"Efficacy of internet-delivered cognitive-behavioral therapy for insomnia\u2014A systematic review and meta-analysis of randomized controlled trials","volume":"30","author":"Zachariae","year":"2016","journal-title":"Sleep Med. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e12967","DOI":"10.1111\/jsr.12967","article-title":"The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment","volume":"29","author":"Baglioni","year":"2020","journal-title":"J. Sleep Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e10113","DOI":"10.2196\/10113","article-title":"The Generalizability of Randomized Controlled Trials of Self-Guided Internet-Based Cognitive Behavioral Therapy for Depressive Symptoms: Systematic Review and Meta-Regression Analysis","volume":"20","author":"Johns","year":"2018","journal-title":"J. Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1001\/jamapsychiatry.2016.3249","article-title":"Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention with 1-Year Follow-up","volume":"74","author":"Ritterband","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1093\/sleep\/32.4.491","article-title":"Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension","volume":"32","author":"Vgontzas","year":"2009","journal-title":"Sleep"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"367","DOI":"10.2147\/NSS.S198812","article-title":"Impact of Phenotypic Heterogeneity of Insomnia on The Patients\u2019 Response to Cognitive-Behavioral Therapy for Insomnia: Current Perspectives","volume":"11","author":"Galbiati","year":"2019","journal-title":"Nat. Sci. Sleep"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1192\/bjpo.bp.117.005231","article-title":"Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression","volume":"3","author":"Batterham","year":"2017","journal-title":"BJPsych Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1080\/15402000701263932","article-title":"Patient Expectations and Therapeutic Alliance as Predictors of Outcome in Group Cognitive-Behavioral Therapy for Insomnia","volume":"5","author":"Constantino","year":"2007","journal-title":"Behav. Sleep Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.brat.2015.07.008","article-title":"Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia","volume":"73","author":"Yeung","year":"2015","journal-title":"Behav. Res. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.5664\/jcsm.3270","article-title":"Predictors of Treatment Response to Brief Behavioral Treatment of Insomnia (BBTI) in Older Adults","volume":"9","author":"Troxel","year":"2013","journal-title":"J. Clin. Sleep Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1037\/0022-006X.69.1.58","article-title":"Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: Analyses of outcome data at 12 months posttreatment","volume":"69","author":"Espie","year":"2001","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e214","DOI":"10.2196\/jmir.4115","article-title":"Adherence to Technology-Mediated Insomnia Treatment: A Meta-Analysis, Interviews and Focus Groups","volume":"17","author":"Horsch","year":"2015","journal-title":"J. Med. Internet Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1177\/0004867418772338","article-title":"Online insomnia treatment and the reduction of anxiety symptoms as a secondary outcome in a randomised controlled trial: The role of cognitive-behavioural factors","volume":"52","author":"Gosling","year":"2018","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"487","DOI":"10.5664\/jcsm.27286","article-title":"Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults","volume":"4","author":"Broch","year":"2008","journal-title":"J. Clin. Sleep Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1037\/a0036606","article-title":"Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: A randomized controlled trial","volume":"82","author":"Harvey","year":"2014","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_26","unstructured":"Morin, C.M. (1993). Insomnia: Psychological Assessment and Management, Guildford Press."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.smrv.2014.01.006","article-title":"The evidence base of sleep restriction therapy for treating insomnia disorder","volume":"18","author":"Miller","year":"2014","journal-title":"Sleep Med. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"797","DOI":"10.5665\/sleep.1878","article-title":"Dismantling Multicomponent Behavioral Treatment for Insomnia in Older Adults: A Randomized Controlled Trial","volume":"35","author":"Epstein","year":"2012","journal-title":"Sleep"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.sleep.2019.01.045","article-title":"A randomized controlled trial comparing guided internet-based multi-component treatment and internet-based guided sleep restriction treatment to care as usual in insomnia","volume":"62","author":"Krieger","year":"2019","journal-title":"Sleep Med."},{"key":"ref_30","unstructured":"American Academy of Sleep Medicine (2014). The International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual, American Academy of Sleep Medicine."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gerber, M., Lang, C., Lemola, S., Colledge, F., Kalak, N., Holsboer-Trachsler, E., P\u00fchse, U., and Brand, S. (2016). Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: Results from three cross-sectional studies. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-0876-8"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kent, P., Cancelliere, C., Boyle, E., Cassidy, J.D., and Kongsted, A. (2020). A conceptual framework for prognostic research. BMC Med. Res. Methodol., 20.","DOI":"10.1186\/s12874-020-01050-7"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"ref_34","unstructured":"Riemann, D., and Backhaus, J. (1996). Behandlung von Schlafst\u00f6rungen, Psychologie. Verlags Union."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1093\/sleep\/30.11.1547","article-title":"Dysfunctional Beliefs and Attitudes about Sleep (DBAS): Validation of a Brief Version (DBAS-16)","volume":"30","author":"Morin","year":"2007","journal-title":"Sleep"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11818-008-0356-6","article-title":"Meinungen-zum-Schlaf-Fragebogen","volume":"13","author":"Weingartz","year":"2009","journal-title":"Somnologie-Schlafforsch Schlafmed."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: A self report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl. Psychol. Meas."},{"key":"ref_38","unstructured":"Hautzinger, M., and Bailer, M. (1993). Allgemeine Depressions-Skala, Beltz Verlag."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.2196\/jmir.1772","article-title":"A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies","volume":"13","author":"Donkin","year":"2011","journal-title":"J. Med. Internet Res."},{"key":"ref_41","first-page":"1","article-title":"mice: Multivariate Imputation by Chained","volume":"45","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"zsab095","DOI":"10.1093\/sleep\/zsab095","article-title":"The natural history of insomnia: Predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia","volume":"44","author":"Ellis","year":"2021","journal-title":"Sleep"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1001\/archinternmed.2008.610","article-title":"The Natural History of Insomnia","volume":"169","author":"Morin","year":"2015","journal-title":"Arch. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1023\/A:1009537722740","article-title":"Predicting Treatment Response in Older Adults with Insomnia","volume":"7","author":"Morin","year":"2001","journal-title":"J. Clin. Geropsychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s10880-011-9250-7","article-title":"Treating Primary Insomnia: Clinical Effectiveness and Predictors of Outcomes on Sleep, Daytime Function and Health-Related Quality of Life","volume":"18","author":"Buyse","year":"2011","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_46","first-page":"zsw012","article-title":"Insomnia Patients with Objective Short Sleep Duration Have a Blunted Response to Cognitive Behavioral Therapy for Insomnia","volume":"40","author":"Bathgate","year":"2017","journal-title":"Sleep"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.sleep.2017.11.1140","article-title":"Cognitive mechanisms of sleep outcomes in a randomized clinical trial of internet-based cognitive behavioral therapy for insomnia","volume":"47","author":"Chow","year":"2018","journal-title":"Sleep Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1001\/jamapsychiatry.2020.1767","article-title":"Effectiveness of Sequential Psychological and Medication Therapies for Insomnia Disorder A Randomized Clinical Trial","volume":"77","author":"Morin","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1016\/j.brat.2004.11.011","article-title":"Sequential combinations of drug and cognitive behavioral therapy for chronic insomnia: An exploratory study","volume":"43","author":"Morin","year":"2005","journal-title":"Behav. Res. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1001\/jama.2009.682","article-title":"Cognitive Behavioral Therapy, Singly and Combined with Medication, for Persistent Insomnia","volume":"301","author":"Morin","year":"2009","journal-title":"JAMA"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1080\/14656566.2018.1511705","article-title":"Making sleep easier: Pharmacological interventions for insomnia","volume":"19","author":"Frase","year":"2018","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.sleep.2018.09.029","article-title":"Cognitive processes mediate the effects of insomnia treatment: Evidence from a randomized wait-list controlled trial","volume":"54","author":"Lancee","year":"2019","journal-title":"Sleep Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1080\/16506073.2015.1026386","article-title":"Sleep-Related Safety Behaviors and Dysfunctional Beliefs Mediate the Efficacy of Online CBT for Insomnia: A Randomized Controlled Trial","volume":"44","author":"Lancee","year":"2015","journal-title":"Cogn. Behav. Ther."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/781\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:36:20Z","timestamp":1760121380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,19]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["diagnostics13040781"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13040781","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,19]]}}}